Rick Santorum delivers serious smackdown on 'Romneycare'

Rick Santorum launched his most cogent attack on Gov. Mitt Romney's health care program in Massachusetts, during Thursday's South Carolina debate.

It took 16 debates, but on the 17th night Rick Santorum finally put the conservative case against Mitt Romney (and, to a lesser extent, Newt Gingrich’s) healthcare histories into a complete package.

This argument has two prongs, which Santorum laid out neatly:

Prong 1, on the politics: “And [Romney]’s going to have to run against a president — he’s going to have to run against a president who’s going to say, ‘well, look, look at what you did for Massachusetts, and you’re the one criticizing me for what I’ve done? I used your model for it.’”

Prong 2, on what’s right: “You’re arguing for a plan; you’re defending a plan that is top-down. It is not a free-market health care system. It is not bottom-up. It is prescriptive and government. It was the basis for Obamacare.”

The full transcript follows, with Gov. Romney and Speaker Gingrich’s remarks. Emphasis in bold by DCDecoder.

CNN's JOHN KING: Senator Santorum, you heard Governor Romney and you heard Speaker Gingrich. Do you trust them if one of them is the Republican party’s nominee and potentially the next president of the United States to repeal this?

FORMER SEN. RICK SANTORUM (R-PA.), PRESIDENTIAL CANDIDATE: The biggest — the biggest thing we have to do is elect a president. I think Newt’s right. The problem is that two of the people up here would be very difficult to elect on, I think, the most important issue that this country is dealing with right now, which is the robbing of our freedom because of Obamacare.

Governor Romney tells a very nice story about what his plan is now. It wasn’t his plan when he was in a position to do a plan. When he was governor of Massachusetts, he put forth Romneycare, which was not a bottom-up free market system. It was a government-run health care system that was the basis of Obamacare, and it has been an abject failure. And he has stood by it. He’s stood by the fact that it’s $8 billion more expensive…

(APPLAUSE)
… than under the current law. He stood by the fact that Massachusetts has the highest health insurance premiums of any state in the country. It is 27 percent more expensive than the average state in the country.

Doctors — if you’re in the Massachusetts health care system, over 50 percent of the doctors now are not seeing new patients — primary care doctors are not seeing new patients. Those who do get to see a patient are waiting 44 days on average for the care. It is an abject disaster. He’s standing by it. And he’s going to have to run against a president — he’s going to have to run against a president who’s going to say, well, look, look at what you did for Massachusetts, and you’re the one criticizing me for what I’ve done? I used your model for it. And then…

(APPLAUSE)
… then we have Speaker Gingrich, who has been — who has been for an individual mandate, not back when the time that just was — Heritage was floating around in the ’90s, but as late as comments since 2008, just a few years ago.
He stood up and said that you should have an individual mandate or post $150,000 bond. How many $150,000 bond holders do we have here who can post a bond for their health insurance?
These are two folks who don’t present the clear contrast that I do, who was the author of health savings accounts, which is the primary basis of every single conservative reform of health care.

(APPLAUSE)
I was the author of it back in 1991 and ‘92, 20 years ago. I’ve been fighting for health reform, private sector, bottom up, the way America works best, for 20 years, while these two guys were playing footise with the left.

KING: I want to bring Congressman Paul — bring you into the discussion in just a moment. But Senator Santorum directly challenged the governor and then the speaker. Governor, you first.

ROMNEY: Well, so much of what the senator said was wrong. Let me mention a few of the things. First of all, the system and my state is not a government-run system. Ninety-two percent of the people had their own insurance before the system was put in place and nothing changed for them. They still had the same private insurance. And the 8 percent of the uninsured, they brought private insurance, not government insurance.
And the people in the state still favor the plan 3-1. And it certainly doesn’t work perfectly. Massachusetts, by the way, had the highest insurance costs before the plan was put in place and after. But fortunately, the rate of growth has slowed down a little less than the overall nation.
And one of the things I was proud of is that individuals who wanted to buy their own insurance saw their rates — when they were not part of a big group — saw their rates drop by some 40 percent with our plan.
Is it perfect? Absolutely not. But I do believe that having been there, having been in the front lines, showing that I have compassion for people that don’t have insurance but that the Obama plan is a 2,700-page massive tax increase, Medicare-cutting monster. I know how to cut it. I’ll eliminate it. I will repeal it. And I’ll return to the — I’ll return the power to the states, where the power for caring for the uninsured ought to reside constitutionally. Thank you.

(APPLAUSE)
KING: Senator Santorum, he says your facts are wrong.

SANTORUM: Well, they’re simply not wrong. The fact is that, yes, you’re right, Governor Romney. Ninety-two percent of people did have health insurance in — in Massachusetts. But that wasn’t private- sector health insurance. A lot of those people were, as you know, on Medicare and Medicaid. So they’re already on government insurance, and you just expanded.
In fact, over half the people that came on the rolls since you put Romneycare into effect are fully subsidized by the state of Massachusetts. And a lot of those are on the Medicaid program.
So the idea that you have created this marketplace in — with this government-run health care system, where you have very prescriptive programs about reimbursements rates. You have very prescriptive programs just like what President Obama is trying to put in place here.
You’re arguing for a plan; you’re defending a plan that is top-down. It is not a free-market health care system. It is not bottom-up. It is prescriptive and government. It was the basis for Obamacare.

(APPLAUSE)
And you do not draw a distinction that’s going to be effective for us just because it was the state level, not the federal level.

(APPLAUSE)
KING: If you want, Governor, quickly?

ROMNEY: Sure, absolutely. First of all, as you probably know, Medicaid is not a state program.

SANTORUM: Of course it is. It’s a state and federal program.

ROMNEY: Medicaid is as demanded by the federal government and it is — it’s a mandate by the federal government and it’s shared 50/50, state and federal.
The people of Massachusetts who are on Medicaid — I would like to end that program at the federal level, take the Medicaid dollars and return them to the states and allow states to craft their own plans. That would make the plan we had in Massachusetts a heck of a lot better.
My view is get the federal government out of Medicaid, get it out of health care. Return it to the states. And if you want to go be governor of Massachusetts, fine. But I want to be president and let states take responsibility for their own plans.

(APPLAUSE)

KING: Mr. Speaker — it may seem like a while ago, Mr. Speaker, but Senator Santorum made the point, in his view, you don’t have credibility on this issue.

GINGRICH: No, what he said, which I found mildly amazing, was that he thought I would have a hard time debating Barack Obama over health care. Now, in fact, I — as Republican whip, I led the charge against Hillarycare in the House. As Speaker of the House, I helped preside over the conference which wrote into law his idea on health savings accounts. So I was delighted to help him get it to be a law.
And the fact is, I helped found the Center for Health Transformation. I wrote a book called “Saving Lives and Saving Money” in 2002. You can go to healthtransformation.net and you’ll see hundreds of ideas, none of which resemble Barack Obama’s programs.
So I’d be quite happy to have a three-hour Lincoln/Douglas style debate with Barack Obama. I’d let him use a teleprompter. I’ll just rely on knowledge. We’ll do fine.

(APPLAUSE)

KING: Senator, I want to bring Congressman Paul in. You’re shaking your head. Quickly.

SANTORUM: The core of Obamacare is an individual mandate. It is what is being litigated in the Supreme Court right now. It is government, top-down, telling every business, every American what kind of health care you will have. That is the problem with Obamacare at the core of it, and the Speaker supported it repeatedly for a 10-year period.
So when he goes and says, I can, you know, run rings around President Obama in a Lincoln/Douglas debate, you can’t run rings around the fact, Newt, that you supported the primary, core basis of what President Obama’s put in place.

GINGRICH: Look, just one —

KING: Quickly, Mr. Speaker. The congressman’s getting lonely down here. Let’s go.

GINGRICH: Just one brief comment. Of course you can. I can say, you know, I was wrong and I figured it out. You were wrong and you didn’t.

(APPLAUSE)

SANTORUM: Newt, you held that position for over 10 years. And, you know, it’s not going to be the most attractive thing to go out there and say it took me 10 or 12 years to figure out I was wrong when guys like Rick Santorum knew it was wrong from the beginning.

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